Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1989 Nov;79(11):1503–1507. doi: 10.2105/ajph.79.11.1503

Nulliparity, decade of first birth, and breast cancer in Connecticut cohorts, 1855 to 1945: an ecological study.

R A Hahn 1, S H Moolgavkar 1
PMCID: PMC1349802  PMID: 2817161

Abstract

Risk of breast cancer increases with age at first birth, and is lower in women who bear their first children while young than in nulliparous women. While previous studies have investigated risk of breast cancer in birth cohorts by examining partial aspects of cohort childbearing, the present ecological study assesses total cohort childbearing risk in Connecticut women born between 1855 and 1945. In each cohort, the proportion of women nulliparous and first bearing children in their twenties, thirties, and forties are weighted by relative risks associated with these events as ascertained in previous studies. Summed cohort childbearing risks are compared to the incidence of breast cancer in women 40 years of age and older in the same cohorts. Changes in decade of first birth and nulliparity do not explain the changes in breast cancer incidence observed: while cohort childbearing risk has declined over the period examined, breast cancer incidence has increased in the same cohorts. Alternative explanations for cohort increases in breast cancer incidence are reviewed.

Full text

PDF
1506

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armstrong B. Recent trends in breast-cancer incidence and mortality in relation to changes in possible risk factors. Int J Cancer. 1976 Feb 15;17(2):204–211. doi: 10.1002/ijc.2910170209. [DOI] [PubMed] [Google Scholar]
  2. Bain C., Willett W., Rosner B., Speizer F. E., Belanger C., Hennekens C. H. Early age at first birth and decreased risk of breast cancer. Am J Epidemiol. 1981 Nov;114(5):705–709. doi: 10.1093/oxfordjournals.aje.a113241. [DOI] [PubMed] [Google Scholar]
  3. Blot W. J. Changing patterns of breast cancer among American women. Am J Public Health. 1980 Aug;70(8):832–835. doi: 10.2105/ajph.70.8.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Breslow N. E., Day N. E. Indirect standardization and multiplicative models for rates, with reference to the age adjustment of cancer incidence and relative frequency data. J Chronic Dis. 1975 Jun;28(5-6):289–303. doi: 10.1016/0021-9681(75)90010-7. [DOI] [PubMed] [Google Scholar]
  5. Brinton L. A., Hoover R., Fraumeni J. F., Jr Reproductive factors in the aetiology of breast cancer. Br J Cancer. 1983 Jun;47(6):757–762. doi: 10.1038/bjc.1983.128. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Byers T., Graham S., Rzepka T., Marshall J. Lactation and breast cancer. Evidence for a negative association in premenopausal women. Am J Epidemiol. 1985 May;121(5):664–674. doi: 10.1093/aje/121.5.664. [DOI] [PubMed] [Google Scholar]
  7. Choi N. W., Howe G. R., Miller A. B., Matthews V., Morgan R. W., Munan L., Burch J. D., Feather J., Jain M., Kelly A. An epidemiologic study of breast cancer. Am J Epidemiol. 1978 Jun;107(6):510–521. doi: 10.1093/oxfordjournals.aje.a112570. [DOI] [PubMed] [Google Scholar]
  8. Hems G. Associations between breast-cancer mortality rates, child-bearing and diet in the United Kingdom. Br J Cancer. 1980 Mar;41(3):429–437. doi: 10.1038/bjc.1980.67. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hems G., Stuart A. Breast cancer rates in populations of single women. Br J Cancer. 1975 Jan;31(1):118–123. doi: 10.1038/bjc.1975.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hendershot G. E. Trends in breast-feeding. Pediatrics. 1984 Oct;74(4 Pt 2):591–602. [PubMed] [Google Scholar]
  11. Hoel D. G., Wakabayashi T., Pike M. C. Secular trends in the distributions of the breast cancer risk factors--menarche, first birth, menopause, and weight--in Hiroshima and Nagasaki, Japan. Am J Epidemiol. 1983 Jul;118(1):78–89. doi: 10.1093/oxfordjournals.aje.a113619. [DOI] [PubMed] [Google Scholar]
  12. Janerich D. T., Hoff M. B. Evidence for a crossover in breast cancer risk factors. Am J Epidemiol. 1982 Nov;116(5):737–742. doi: 10.1093/oxfordjournals.aje.a113462. [DOI] [PubMed] [Google Scholar]
  13. MACMAHON B. Breast cancer at menopausal ages: an explanation of observed incidence changes. Cancer. 1957 Sep-Oct;10(5):1037–1044. doi: 10.1002/1097-0142(195709/10)10:5<1037::aid-cncr2820100526>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  14. MACMAHON B. Cohort fertility and increasing breast cancer incidence. Cancer. 1958 Mar-Apr;11(2):250–254. doi: 10.1002/1097-0142(195803/04)11:2<250::aid-cncr2820110204>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  15. MacMahon B., Cole P., Lin T. M., Lowe C. R., Mirra A. P., Ravnihar B., Salber E. J., Valaoras V. G., Yuasa S. Age at first birth and breast cancer risk. Bull World Health Organ. 1970;43(2):209–221. [PMC free article] [PubMed] [Google Scholar]
  16. MacMahon B., Lin T. M., Lowe C. R., Mirra A. P., Ravnihar B., Salber E. J., Trichopoulos D., Valaoras V. G., Yuasa S. Lactation and cancer of the breast. A summary of an international study. Bull World Health Organ. 1970;42(2):185–194. [PMC free article] [PubMed] [Google Scholar]
  17. McKinlay S., Jefferys M., Thompson B. An investigation of the age at menopause. J Biosoc Sci. 1972 Apr;4(2):161–173. doi: 10.1017/s0021932000008464. [DOI] [PubMed] [Google Scholar]
  18. McTiernan A., Thomas D. B. Evidence for a protective effect of lactation on risk of breast cancer in young women. Results from a case-control study. Am J Epidemiol. 1986 Sep;124(3):353–358. doi: 10.1093/oxfordjournals.aje.a114405. [DOI] [PubMed] [Google Scholar]
  19. Mirra A. P., Cole P., MacMahon B. Breast cancer in an area of high parity: São Paulo, Brazil. Cancer Res. 1971 Feb;31(2):77–83. [PubMed] [Google Scholar]
  20. Moolgavkar S. H., Day N. E., Stevens R. G. Two-stage model for carcinogenesis: Epidemiology of breast cancer in females. J Natl Cancer Inst. 1980 Sep;65(3):559–569. [PubMed] [Google Scholar]
  21. Moolgavkar S. H., Lee J. A., Hade R. D. Comparison of age-specific mortality from breast cancer in males in the United States and Japan. J Natl Cancer Inst. 1978 Jun;60(6):1223–1225. doi: 10.1093/jnci/60.6.1223. [DOI] [PubMed] [Google Scholar]
  22. Moolgavkar S. H., Stevens R. G., Lee J. A. Effect of age on incidence of breast cancer in females. J Natl Cancer Inst. 1979 Mar;62(3):493–501. doi: 10.1093/jnci/62.3.493. [DOI] [PubMed] [Google Scholar]
  23. Pike M. C., Henderson B. E., Casagrande J. T., Rosario I., Gray G. E. Oral contraceptive use and early abortion as risk factors for breast cancer in young women. Br J Cancer. 1981 Jan;43(1):72–76. doi: 10.1038/bjc.1981.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Pike M. C., Krailo M. D., Henderson B. E., Casagrande J. T., Hoel D. G. 'Hormonal' risk factors, 'breast tissue age' and the age-incidence of breast cancer. Nature. 1983 Jun 30;303(5920):767–770. doi: 10.1038/303767a0. [DOI] [PubMed] [Google Scholar]
  25. Rosenberg L., Miller D. R., Kaufman D. W., Helmrich S. P., Stolley P. D., Schottenfeld D., Shapiro S. Breast cancer and oral contraceptive use. Am J Epidemiol. 1984 Feb;119(2):167–176. doi: 10.1093/oxfordjournals.aje.a113735. [DOI] [PubMed] [Google Scholar]
  26. Stavraky K., Emmons S. Breast cancer in premenopausal and postmenopausal women. J Natl Cancer Inst. 1974 Sep;53(3):647–654. doi: 10.1093/jnci/53.3.647. [DOI] [PubMed] [Google Scholar]
  27. Stevens R. G. Electric power use and breast cancer: a hypothesis. Am J Epidemiol. 1987 Apr;125(4):556–561. doi: 10.1093/oxfordjournals.aje.a114569. [DOI] [PubMed] [Google Scholar]
  28. Stevens R. G., Moolgavkar S. H., Lee J. A. Temporal trends in breast cancer. Am J Epidemiol. 1982 May;115(5):759–777. doi: 10.1093/oxfordjournals.aje.a113358. [DOI] [PubMed] [Google Scholar]
  29. Thein-Hlaing, Thein-Maung-Myint Risk factors of breast cancer in Burma. Int J Cancer. 1978 Apr 15;21(4):432–437. doi: 10.1002/ijc.2910210406. [DOI] [PubMed] [Google Scholar]
  30. Tulinius H., Day N. E., Jóhannesson G., Bjarnason O., Gonzales M. Reproductive factors and risk for breast cancer in Iceland. Int J Cancer. 1978 Jun 15;21(6):724–730. doi: 10.1002/ijc.2910210609. [DOI] [PubMed] [Google Scholar]
  31. Vessey M. P., McPherson K., Yeates D., Doll R. Oral contraceptive use and abortion before first term pregnancy in relation to breast cancer risk. Br J Cancer. 1982 Mar;45(3):327–331. doi: 10.1038/bjc.1982.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. White E. Projected changes in breast cancer incidence due to the trend toward delayed childbearing. Am J Public Health. 1987 Apr;77(4):495–497. doi: 10.2105/ajph.77.4.495. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Wigle D. T. Breast cancer and fertility trends in Canada. Am J Epidemiol. 1977 May;105(5):428–438. doi: 10.1093/oxfordjournals.aje.a112401. [DOI] [PubMed] [Google Scholar]
  34. Wyshak G., Frisch R. E. Evidence for a secular trend in age of menarche. N Engl J Med. 1982 Apr 29;306(17):1033–1035. doi: 10.1056/NEJM198204293061707. [DOI] [PubMed] [Google Scholar]
  35. de Waard F. The epidemiology of breast cancer: review and prospects. Int J Cancer. 1969 Sep 15;4(5):577–586. doi: 10.1002/ijc.2910040502. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES